{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:02:04Z","timestamp":1784512924143,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Rhinosinusitis contributes to the development of sleep-disordered breathing (SDB) by causing nasal obstruction and airway inflammation; however, the extent to which treatment improves these conditions remains unclear. To address this, this study systematically evaluated the impact of rhinosinusitis-directed therapy on nasal symptoms, endoscopic findings, and sleep-related respiratory parameters. Materials and Methods: Methodologically, this systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search was conducted across the PubMed, Medline, Web of Science, Science Direct, and Google scholar databases. Specifically, studies reporting pre- and post-treatment outcomes in patients with rhinosinusitis were included. Due to substantial clinical and methodological heterogeneity among the included studies, a quantitative meta-analysis was not performed; instead, findings were synthesized narratively. Results: Ultimately, fifteen studies met the inclusion criteria and demonstrated consistent improvements in sleep-related outcomes following the treatment of rhinosinusitis. Across the surgical and medical interventions, reductions in apnea-hypopnea index (AHI) and improvement in endoscopic findings were frequently reported. For instance, functional endoscopic sinus surgery (FESS) produced notable enhancements in sleep quality, daytime sleepiness, and sinonasal symptom scores in several studies, while biologic therapy and medical management also showed benefit in reducing nasal obstruction, rhinorrhea, and inflammatory markers. Conclusions: The available evidence suggests that rhinosinusitis treatment may be associated with improvements in measures of sleep-disordered breathing (SDB) and mucosal inflammation, although subjective nasal symptom outcomes were more variable across studies. Consequently, targeted sinonasal therapy may play an important role in reducing SDB burden, particularly in patients with inflammatory airway compromise.<\/jats:p>","DOI":"10.3390\/medicina62071392","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:47:32Z","timestamp":1784508452000},"page":"1392","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Rhinosinusitis and Its Treatment on Sleep-Disordered Breathing: A Systematic Review"],"prefix":"10.3390","volume":"62","author":[{"given":"Taif Mansour","family":"Almaqboul","sequence":"first","affiliation":[{"name":"College of Medicine, Batterjee Medical College, Jeddah 21442, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal Kharallah","family":"Almutairi","sequence":"additional","affiliation":[{"name":"College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lujain Barkheel","family":"Albarkheel","sequence":"additional","affiliation":[{"name":"College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9251-2398","authenticated-orcid":false,"given":"Atheer Mohammed","family":"Alshammakhi","sequence":"additional","affiliation":[{"name":"College of Medicine, Jazan University, Jazan 45142, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehaf A.","family":"Areeshi","sequence":"additional","affiliation":[{"name":"College of Medicine, Jazan University, Jazan 45142, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Ahmed","family":"Alarfaj","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Surgery Department, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3434-8035","authenticated-orcid":false,"given":"Khalid","family":"AlYahya","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Surgery Department, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"ref_1","unstructured":"Sankari, A., Maggard, M.D., and Cascella, M. (2025, November 26). Upper Airway Resistance Syndrome, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK564402\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.smrv.2016.07.002","article-title":"Prevalence of obstructive sleep apnea in the general population: A systematic review","volume":"34","author":"Senaratna","year":"2017","journal-title":"Sleep Med. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1161\/CIRCRESAHA.125.325676","article-title":"Obstructive Sleep Apnea and Cardiometabolic Disease: Obesity, Hypertension, and Diabetes","volume":"137","author":"Tasali","year":"2025","journal-title":"Circ. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S757","DOI":"10.1016\/S0091-6749(97)70124-6","article-title":"Nasal obstruction as a risk factor for sleep-disordered breathing","volume":"99","author":"Young","year":"1997","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1038\/s41392-023-01496-3","article-title":"Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome","volume":"8","author":"Lv","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/14787210.2017.1294063","article-title":"Sleep disruption in chronic rhinosinusitis","volume":"15","author":"Mahdavinia","year":"2017","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"899","DOI":"10.5664\/jcsm.7846","article-title":"Incident Chronic Rhinosinusitis Is Associated with Impaired Sleep Quality: Results of the RHINE Study","volume":"15","author":"Bengtsson","year":"2019","journal-title":"J. Clin. Sleep Med."},{"key":"ref_8","first-page":"e92274","article-title":"Efficacy of Topical Corticosteroid Therapy in Chronic Rhinosinusitis Post-endoscopic Sinus Surgery: A Narrative Synthesis of Randomized Controlled Trials","volume":"17","author":"Alharbi","year":"2025","journal-title":"Cureus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1002\/alr.21682","article-title":"Improvements in sleep-related symptoms after endoscopic sinus surgery in patients with chronic rhinosinusitis","volume":"6","author":"Mace","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13643-018-0699-4","article-title":"Registration of systematic reviews in PROSPERO: 30,000 records and counting","volume":"7","author":"Page","year":"2018","journal-title":"Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Sterne, J.A.C., Hern\u00e1n, M.A., Reeves, B.C., Savovi\u0107, J., Berkman, N.D., Viswanathan, M., Henry, D., Altman, D.G., Ansari, M.T., and Boutron, I. (2016). ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions. BMJ, 355, Available online: https:\/\/www.bmj.com\/content\/355\/bmj.i4919.","DOI":"10.1136\/bmj.i4919"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.anl.2017.01.015","article-title":"The evaluation of pattern and quality of sleep in patients with chronic rhinosinusitis with nasal polyps","volume":"44","author":"Uz","year":"2017","journal-title":"Auris Nasus Larynx"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"390","DOI":"10.21053\/ceo.2020.02250","article-title":"Effect of obstructive sleep apnea on immunity in cases of chronic rhinosinusitis with nasal polyps","volume":"14","author":"Kim","year":"2021","journal-title":"Clin. Exp. Otorhinolaryngol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4193\/Rhin16.065","article-title":"Sleep quality improves with endoscopic sinus surgery in patients with chronic rhinosinusitis and nasal polyposis","volume":"55","author":"Johannisson","year":"2017","journal-title":"Rhinology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1002\/ohn.934","article-title":"Obstructive sleep apnea and chronic rhinosinusitis: Understanding the impact of OSA on CRS disease burden","volume":"171","author":"Garvey","year":"2024","journal-title":"Otolaryngol. \u2013Head Neck Surg."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Moffa, A., Iafrati, F., Giorgi, L., Nardelli, D., Carnuccio, L., Baptista, P., Olszewska, E., and Casale, M. (2025). Clinical Evidence of the Use of Mepolizumab in the Treatment of Chronic Rhinosinusitis with Nasal Polyps: A Prospective Observational Study. Healthcare, 13.","DOI":"10.3390\/healthcare13040419"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1002\/alr.21488","article-title":"The impact of sinus surgery on sleep outcomes","volume":"5","author":"Rotenberg","year":"2015","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_20","first-page":"146","article-title":"Pediatric acute and chronic rhinosinusitis: Comparison of clinical characteristics and outcome of treatment","volume":"30","author":"Poachanukoon","year":"2012","journal-title":"Asian Pac. J. Allergy Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"75","DOI":"10.4193\/Rhino15.204","article-title":"The impact of chronic rhinosinusitis on sleep-disordered breathing","volume":"54","author":"Jiang","year":"2016","journal-title":"Rhinology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2500\/ar.2017.8.0195","article-title":"Quality-of-life improvement after endoscopic sinus surgery in patients with obstructive sleep apnea","volume":"8","author":"Tajudeen","year":"2017","journal-title":"Allergy Rhinol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"7951045","DOI":"10.1155\/2019\/7951045","article-title":"The influence of functional endoscopic sinus surgery on sleep related outcomes in patients with chronic rhinosinusitis","volume":"2019","author":"Jiang","year":"2019","journal-title":"Int. J. Otolaryngol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.anai.2017.03.009","article-title":"Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis","volume":"118","author":"Hui","year":"2017","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1001\/jamaoto.2021.0011","article-title":"Oral corticosteroids following endoscopic sinus surgery for chronic rhinosinusitis without nasal polyposis: A randomized clinical trial","volume":"147","author":"Chang","year":"2021","journal-title":"JAMA Otolaryngol. \u2013Head Neck Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/alr.21364","article-title":"Sleep and quality of life improvements after endoscopic sinus surgery in patients with chronic rhinosinusitis","volume":"4","author":"Alt","year":"2014","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"103079","DOI":"10.1016\/j.amjoto.2021.103079","article-title":"Relationship between allergic rhinitis and nasal surgery success in patients with obstructive sleep apnea","volume":"42","author":"Kim","year":"2021","journal-title":"Am. J. Otolaryngol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.amsu.2019.03.001","article-title":"Quality of life outcomes of patients with chronic rhinosinusitis after functional endoscopic sinus surgery, prospective cohort study","volume":"40","author":"Laababsi","year":"2019","journal-title":"Ann. Med. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2548386","DOI":"10.1080\/07853890.2025.2548386","article-title":"The importance of dopamine levels and single-nucleotide polymorphism within COMT, DRD1 and DRD2 genes in obstructive sleep apnoea","volume":"57","author":"Smardz","year":"2025","journal-title":"Ann. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1392\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T01:20:14Z","timestamp":1784510414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["medicina62071392"],"URL":"https:\/\/doi.org\/10.3390\/medicina62071392","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,18]]}}}